1. Northern Calif. Junior Field Representative
Laurie Crowe
Phone: (530)
Public and Private providers in the following counties:
Del Norte, Glenn, Humboldt, Lassen, Modoc, Shasta, Siskiyou, Tehama, Trinity
I cover the public and private providers in the 9 most northern counties

2. Your Field Rep is one of your Valuable Resources
We are there to back you up
We work together to ensure the children are properly vaccinated
Deal with the issues that may create a bad relationship between you and a provider
Help located vaccine during an outbreak situation
Get to be the bad guy

3. Vaccines = Money
VFC vaccine is not really FREE vaccines We all pay for it with our tax payer dollars

4. CDC pricing for 10 doses of each vaccine over $6,000
Brandname/ Tradename
Manufacturer
CDC Cost/Dose
Number of Doses
Total
DTaP
Tripedia®
Sanofi Pasteur
$13.25 10
$132.50
DTaP-Hep B-IPV
Pediarix®
GlaxoSmithKline
$48.75
$487.50
DTaP - IPV - HIB
Pentacel
$51.49
$514.90
DTaP - IPV
Kinrix
$32.25
$322.50
e-IPV
IPOL®
$11.51
$115.10
Hepatitis A Pediatric
VAQTA®
Merck
$13.00
$130.00
Hepatitis B Peds
ENGERIX B®
$9.50
$95.00
Hib
ActHIB®
$8.66
$86.60
HPV -
Gardasil®
$105.58
$1,055.80
Meningococcal Con
Menactra®
$80.13
$801.30
MMR
MMRII®
$18.30
$183.00
PVC-7 Pediatric
Prevnar®
Wyeth/Lederle
$71.04
$710.40
Rotavirus,
RotaTeq®
$57.20
$572.00
Tdap
ADACEL®
$30.75
$307.50
Varicella
Varivax®
$64.53
$645.30
$6,159.40
Revised 6-09
10 doses of each vaccine is well over $6,000

5. When a storage problem is discovered data needs collected and the report submitted to VFC
Report sent to VFC

6. Details to determine if the vaccine is spoiled or not.
How long was it out of range?
Why was it out of range?
What happened ~ door left open? ~ power went out?
What vaccines were involved ~ inventory list
How long was it out of range and what happened

7. Review temp logs ~ Is unit normally stable?
Which vaccines are still ok ~ Freezer out of range but MMR refrigerator stable
Review temp logs ~ Is unit normally stable?
What type of thermometer are they using ~ does it work right
How can it be prevented from happening again?
How can it be prevented from happening again

8. Sometimes its obvious and other times we have to refer to someone like Sandra Jo or the manufacturer for final decision
Most Important!
Keep the vaccine isolated but stored correctly until final decision is made
Keep isolated and stored correctly

9. Providers want to do the right thing they just need educated.
Unfortunately some have purchased units that are not approved and the unit are for the most part an over sized dorm unit.
I believe the providers want to do the right thing they just need educated some purchase the wrong units

10. I explain that the refrigerator works off of the freezer
When I find a provider using a combination unit I give them my frig 101 lesson
I explain that the refrigerator works off of the freezer
I point out where their air output vent is and that being the air comes from the freezer the air can be as cold as 29 degrees when it enters the refrigerator.
I also stress that that the way a combo unit is designed it is hard to keep the freezer at 5 degrees and the refrigerator at 40 degrees.
The 2 sections fight each other
Frig 101 the 2 sections fight each other its just nature of the beast

11. $600 refrigerator “vs” $10,000 vaccine loss
I tell them that if they replace their unit with a stand alone it is sort of like an insurance policy
$600 refrigerator “vs” $10,000 vaccine loss
If they had a loss that was boarding on neglect if they have already replaced their unit with a stand-alone more than likely we wouldn’t consider it neglect.
Insurance policy $600 vs $10,000

12. Units that I have found in the field
Units in the field

13. This is a cycle defrost water accumulates on the back wall and freezes
This one is a cycle defrost danby ice cake

14. This unit was advertised online as a Medical grade unit for $800.00
Only thing medical grade I could find is the plug and the cord.
Problems with this unit included
Metal backing that had visible ice
Thermometer is mounted on the back lower corner and cannot be moved
The manual talked about food safety and had nothing regarding medical storage
only thing medical grade I could find was the plug and the cord the company didn’t even bother to take new pictures with medical supplies in the unit

15. Be warned Medical grade units are NOT Pharmacy grade
Call your VFC Rep with model number before buying
Read the description
Read the manual if it says cycle defrost do not buy.
We do not like to see providers get the wrong unit call us with model number before buying

16. Vaccines must be stored and handled correctly to work!

17. Would you use vaccine from a unit like this?
I found this unit in a scrap yard being used for water and lunches but I have found freezers in the dorm units that do look like this

18. Do not store vaccine out of their package
Even pre filled hanging from wires

19. This one is at a large CHC went from a combination to a stand alone
The stand alone units has made a big difference this CHC has a pharmacy grade and 3 stand alones throughout their clinic

20. Frig to tall staff need step stool let staff in on decision making

21. This one at a Public Health clinic The coordinator has it well organized
This one is at one of my public health clinics she's colored coded it and has it well organized

22. Examples of Appropriate Storage Units
Refrigerators
Household Grade
This is what we would like to see in offices
Pharmacy/Biologic Grade
Commercial Grade
Pharmacy Grade Under-the-Counter

23. Many units need retired
There are many units we encounter that we would like to see retired or at least not purchased or used
Many units need retired